Randomized evaluation of four versus five French catheters for transfemoral coronary angiography

Background and hypothesis: in coronary angiography there is a trend toward using smaller catheters to avoid puncture site complications. An increased utilization of outpatient facilities may result. This study was undertaken to determine whether using 4Fr diagnostic catheters in comparison with 5Fr catheters would reduce the vascular complication rate, after patient ambulation following 4 h bedrest, without altered technical performance and or procedural duration. Methods: The study population comprised 100 consecutive, unselected patients, who were randomly assigned for transfemoral coronary angiography with 4 or 5Fr diagnostic catheters. Procedural characteristics, quality of angiogram, and clinical assessment of puncture site at 4, 12, and 24 h were analyzed. Results: No significant difference was demonstrated concerning procedural characteristics, ventriculography, coronary contrast quality, or local vascular damage. However, two patients crossed over in the 4Fr group and one in the 5Fr group. Conclusion: As a consequence, the feasibility, reliability, and utility of catheter size on vascular complication rates must be considered to be similar with either 4Fr or 5Fr diagnostic catheters.